Tests and diagnosis

Diagnosing drug addiction (also called substance use disorder) requires a thorough evaluation and often includes an assessment by a psychiatrist, a psychologist, or a licensed alcohol and drug counselor. Blood, urine or other lab tests are used to assess drug use, but they're not a diagnostic test for addiction. These tests may be used for monitoring treatment and recovery.

For diagnosis of a substance use disorder, most mental health professionals use criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, to diagnose mental conditions. This manual is also used by insurance companies to reimburse for treatment.

DSM-5 criteria for substance use disorder include a behavior pattern of drug use that causes significant problems and distress, regardless of what drug is used.

You may have a substance use disorder if at least two of these issues occur within a 12-month period:

You often take larger amounts of the drug over a longer period of time than you intended

You want to cut down or quit, but haven't been successful

You spend a good deal of time getting the drug, using the drug or recovering from the effects of the drug

You have intense urges for the drug that block out any other thoughts

You aren't meeting obligations and responsibilities because of your substance use

You keep using the drug, even though you know it's causing problems in your life

You give up or cut back important social, occupational or recreational activities because of your substance use

You use the substance in situations that may be unsafe, such as when driving or operating machinery

You use the substance even though you know it's causing you physical or psychological harm

You develop tolerance, which means that the drug has less and less effect on you and you need more of the drug to get the same effect

You have physical or psychological withdrawal symptoms when you stop taking the drug, or you take the drug (or a similar drug) to avoid withdrawal symptoms

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